Pediatric Triage Information

First responders arriving at any emergency where there are multiple victims use triage guidelines to deal with the various injuries. The notion of triaging victims at large-scale incidents was first raised in the 1700s, and was refined over the years. It is now the standard for major incidents like airplane crashes and the bombing of a federal building in Oklahoma City. Triage guidelines specifically for children were developed in 1995.

• Pediatric triage guidelines help assure the most seriously injured victims at a multi-casualty event get help first.

The Facts

• The term triage stems from the French verb trier, which means to separate or sort. The concept is used in the medical field to simply, and quickly, identify the most severely injured people and get them help immediately. The idea of doing so was first incorporated into the Napoleonic wars in the 1790s by French surgeon Dominique Jean Larrey.

Types

• The most common form of triage is the Simple Triage and Rapid Treatment (START) format. START was developed in 1983 by the Hoag Hospital and the Newport Beach Fire Department, according to Start-Triage.com. Simply put, the triage guidelines allow first responders to deploy their resources at multi-casualty events. Another form of triage called the The Sacco Triage Method, developed by Dr. Bill Sacco, gives victims a score based on the expected outcome in consideration of the timing and availability of transport and treatment resources, according to the website Sharpthinkers.com.

  However, most triage systems are designed for adults, not children. So, in 1995, Dr. Lou Romig introduced the JumpSTART form of triage to provide aid to children at multi-casualty disasters, which takes into consideration the dramatic differences between adults and children.

History

• Focusing on the differences between adults and children, Dr. Lou Romig, a doctor at the Miami Children's Hospital since 1989, created the JumpSTART form of triage specifically for children between the ages of 1 and 8. Whereas the START system for adults relies on victims being able to answer questions, Romig noted that children may not be able to respond to basic commands. Likewise, she noted there are major differences in the way children's bodies react, so using the guidelines for adults may not be appropriate.

Time Frame

• When dealing with victims of traumatic injuries, first responders have what they call the "golden hour." The goal is to get injured victims from the scene of the incident to the operating room within an hour. Triage guidelines, specifically, pediatric triage guidelines, help EMS providers get that done. With a pediatric triage system, emergency medical services staffers can size up injured children within one minute and quickly classify each injured child. Children are classified by colors. Green is for minor injuries. Yellow is for injuries where treatment can be slightly delayed. Red indicates immediate help needed. And black is for those who are dead. As with adults, pediatric victims are triaged before treatment or transportation to hospitals begins.

Benefits

• Besides the references to differences in children and adults, one of the concepts behind Romig's JumpSTART program is taking into consideration how emergency responders react when children are involved. The system provides an "objective" framework that ensures children are triaged by responders "using their heads instead of their hearts," according to Jumpstarttriage.com. As with adults, by using triage guidelines, EMS personnel must be aware that they are making life and death decisions. As a result, they are getting the best help to the people most likely to survive, and not using resources on those who may die anyway.